化学療法を受けるがん患者に対する看護の実践状況と関連要因

The Status of Nursing Practice for Cancer Patients Receiving Chemotherapy and Factors related to the Practice of Nursing

要旨

　本研究の目的は，化学療法を受けるがん患者に対する看護の実践状況と看護実践に関連する要因を明らかにすることである．がん化学療法看護に携わる看護師205名を対象に，化学療法を受けるがん患者に対する看護の実践状況を問う自記式質問紙調査を行った．回収は160部で，そのうち記入漏れのあった21部を除いた139部を分析対象とした．分析は，記述統計量，Spearmanの相関係数，Mann-WhitneyのU検定およびKruskal Wallis検定を用いた．その結果，副作用症状の把握に関するケアや精神面，理解に対するケアの実践度が高い一方，セルフマネジメントや日常生活を見据えたケアの実践度が低かった．看護実践に影響する要因として，化学療法看護の経験年数，職位の有無，化学療法看護の講習の受講経験の有無，病院の種類，化学療法認定看護師の有無において有意差がみられ，化学療法看護に対する関心と実践度の関係においては正の相関がみられた．これらのことより，日常生活を見据えたケアと知識を個々の患者のケアに反映していく取り組みの必要性が示唆された．また，施設においても看護師が関心を持つような取り組みや教育体制の充実を図っていく必要性が示唆された．

Abstract

　The objective of this study was to clarify the status of nursing practice for cancer patients receiving chemotherapy and factors related to the practice of nursing. A self-written questionnaire survey was carried out on 205 nurses engaged in cancer chemotherapy nursing. Responses to the questionnaire were retrieved from 160 nurses, of which 21 incomplete responses were excluded. The remaining 139 responses were subjected to analysis using descriptive statistics, Spearman's rank correlation coefficient, the Mann-Whitney U test and the Kruskal-Wallis test. The survey revealed a high degree of practice for care concerning comprehension of symptoms of adverse reactions, care about mental aspects of the patient and care about understanding of the patient, whereas the degree of practice was low for care to be taken by intensive assessment of self-management and daily living activities. Among factors affecting nursing practice, statistical differences were demonstrated for the number of years of experience in chemotherapy nursing, job title, experience of attending training courses on chemotherapy nursing, type of hospital, and the presence or absence of nurses certified in chemotherapy nursing. The analysis showed a positive correlation between interest in chemotherapy nursing and degree of practice. These results suggested a need for a strategy that would reflect the care taken by looking intensively at daily living activities and knowledge thereof in caring for individual patients. The results also suggest the need to make efforts to evoke the interest of nurses and to enrich the educational system as part of the medical institutions.